Dear Dr. Roach: In a recent column, you discussed an antihistamine and montelukast for allergies. We use pure essential oil. Lavender is better than drugs.
Dear J.O.S.: I consider any substance that is taken to relieve a medical symptom or to cure or prevent a disease to be medication, or a drug.
For centuries, if not millennia, the drugs in the pharmacopeia mostly were derived from plants. This might mean the whole plant leaf (such as foxglove) or powdered bark (from the willow tree), both of which still are valued and commonly used medications, only they have been purified and standardized as digoxin and aspirin, respectively.
Lavender essential oils can be made several ways, including steam distillation and enfleurage (using a solvent fat to capture the essential oil, then extracting the plant oil with alcohol). All of the methods capture chemicals of interest from within the plant: With lavender, there are over 100 known compounds; among the most sought-after are linalool, perillyl alcohol and linalyl acetate.
If used on the skin, they are quickly absorbed into the blood. So, when you are using lavender essential oil as a medication, you are using an unregulated and largely unstudied mixture of compounds. That isn’t necessarily a bad thing: Humans have been using essential oils medicinally for centuries, and lavender is considered generally safe. Lavender as aromatherapy has been tested and found to be effective in reducing anxiety, for example.
However, don’t think that natural products like lavender oil are free of side effects. Any substance has the potential for harm, in the right person and at the right concentration. Lavender oil contains compounds that have female hormone (estrogen) activity and inhibit male hormones (androgens), so use of lavender oil on the skin has been reported to cause gynecomastia (breast development) in boys near puberty. Lavender also has coumarins (naturally occurring chemicals that are also found in clover, from which warfarin, or Coumadin, originally was derived), which in theory might lead to bleeding complications in people so predisposed.
Dear Dr. Roach: A recent column included details about Type 2 diabetes. As a precaution for older guys like me (over 80), please explain the testing to ascertain whether that disease is present or not. I know that tests — A1C, for instance — can give some guidance.
What are the test levels (normal, borderline, high)? I am always careful about things that may eventually lead to Type 2, which I want to avoid.
Dear G.M.: There are now several ways to make the diagnosis of diabetes, but the A1C test, a measurement of the amount of sugar on hemoglobin, is probably the most common. It is also how we monitor its control. There is no universally accepted cutoff point for the A1C level, but the American Diabetes Association has guidelines that are widely used. Normal is 5.6 percent or less. Increased risk, also called prediabetes or impaired glucose tolerance, is 5.7 percent to 6.4 percent. Diabetes is 6.5 percent and above.
Regular exercise, meaning weight-training or aerobic exercise for at least 150 minutes per week, reduces the risk of diabetes. There are several types of diets that also reduce diabetes risk: All of these avoid excessive sweets and processed starches. A few pounds of weight loss can make a dramatic difference in risk, as well.
Email questions to ToYourGoodHealth @med.cornell.edu.